We are NOT authorized by Govt of India for Yellow Fever Vaccination

Friday, June 17, 2016

The yellow fever vaccination facility was inaugurated by Megha Pravin Khobragade, Deputy Assistant Director General (International Health), Ministry of Health and Family Welfare, Government of India, in the presence of S. Anantha Chandra Bose, Chairman, V.O. Chidambaranar Port Trust, and S. Natarajan, Deputy Chairman, on the port premises on Wednesday.

According to a statement issued here on Thursday, Dr. Khobragade said it was the 35th centre in the country to administer yellow fever vaccination and it would help travellers save money and time.

Mr. Bose thanked the officials of the Ministry of Health and Family Welfare for considering the request of the port and establishing the facility within a short period. The new facility would help the Export-Import (EXIM) community in a big way, he said.

Port Health Organisation would organise vaccination from 11 a.m. to 1.p.m. every Tuesday. The charge for vaccination and issue of certificate would be Rs. 300. Intending travellers could avail themselves of this facility by registering their names through email: photuticorin@gmail.com, phone: 0461-2353341, fax: 0461-2353314 and mobile: 9865436526, the statement added.

Thursday, June 16, 2016

I got my yellow fever shot today at the Airport Health Organisation Office at Chhatrapati Shivaji International Airport.I reached there around 8:00 AM, and there was an informal list circulating managed by the people themselves, there were already 40 names on it (the list seems to have started at 2 AM). It was a long wait in the sun outside the gates and by the time we were allowed to enter around 9:45 AM there were about 60 odd people in the line (70 allowed per day max). Inside the office there is a decent AC waiting hall with comfortable chairs and a small canteen where one can have some break fast (Bhaji pao, poha, tea & water).1. The forms were distributed and the person there was pretty helpful in guiding the people.2. The forms were submitted and payment (Rs. 300.00) made.3. Around 11:30 AM the injections started with the first batch of 30 people being called.4. After another 20 minutes or so the rest of us were called and taken to the 1st floor where there is another waiting hall.5. First to be injected were ladies and children.6. Next the men, the process took less than 15 sec. (the doctor is so efficient that I did not even realize that I had been injected).7. After waiting for another 10 minutes the certificates were distributed which had to be filled with Name, PP number, date etc.8. Finally the certificates were collected back and signed.9. The whole process took about 3 hours (from entering the premises)

Do's:1. Carry your passport (original), copies are not accepted2. Carry your confirmed ticket3. You need to reach early to make it within the 70 which are admitted in a day.4. The injection is in batches of 10 only. In case there are 69 people then only 60 will be injected. The rest 9 will have to come back some other day.

Ethiopia is the latest African nation to record cases of yellow fever cases following an outbreak of the disease in Angola last year.

According to the United Nations, about 22 suspectedcases of yellow fever have been reported in Ethiopia. One case has been recorded in the Republic of Congo and two in Sao Tome.

An investigation to determine if the cases are connected to the outbreak in Angola is ongoing. Health officials will try to identify the vaccination status of the patients involved in these cases.

The yellow fever outbreak in Angola began in December 2015. As of June 2016, over 2000 suspected cases of the disease have been reported in the country. Up to 788 of these cases have been confirmed by lab tests and about 325 people have died from the disease.

Despite an aggressive vaccination campaign, the disease has continued to spread.

Health officials from the DRC have confirmed a connection between yellow fever in their country the outbreak of the disease in Angola. About 41 cases have been traced to people who recently traveled to or from Angola. The infections are mainly concentrated in the cities.

The World Health Organization (WHO) is assisting the national authorities of the affected countries to combat the disease. About 1,983,507 people in Kongo Central and Kinshasa have reportedly been vaccinated.

Angola has reportedly vaccinated nearly half of its population. However, health officials have expressed concern over the high risk of the disease spreading. There are also concerns that non-immunized travelers can spread the disease internationally.

Wednesday, June 15, 2016

Lusaka: Health authorities in Zambia said on Friday that surveillance measures have been heightened in border areas following an outbreak of yellow fever in Angola and the Democratic Republic of Congo (DRC).

Yellow fever has been raging since last December in Angola, especially in the capital Luanda, killing 293 people to date and infecting another 2,267. Cases have also been imported to Kinshasa in DRC, Xinhua reported.

Deputy Minister of Health Chitalu Chilufya said the ministry was currently monitoring the situation on the two neighbouring countries and has since heightened activities that will prevent the spread of the disease into the country.

The official however said so far no yellow fever has been reported in the country, local HOT FM radio reported.

Tuesday, June 14, 2016

Four cases of Yellow Fever have been recorded in the Brong-Ahafo and Volta regions over the last one month, the Ghana Health service has announced.

No casualty has, however, been recorded.

A statement cautioning Ghanaians about the disease noted that there is no need to panic since the virus is being contained.

Below are details of the statement

CONFIRMED CASES OF YELLOW FEVER (YF) - BRONG-AHAFO AND VOLTA REGIONS

Over the past four weeks, the Ghana Health Service has received reports of confirmed Yellow Fever (YF) cases from the Brong-Ahafo and Volta regions.

A total of four cases with no deaths have been reported.

Three (3) are from Jaman South district in the Brong-Ahafo region & one (1) from Central Tongu district in the Volta Region.

*THERE IS NO NEED TO PANIC AS THE CASES ARE CONFINED TO A FEW COMMUNITIES IN THE AFOREMENTIONED DISTRICTS, AND PREVIOUS WIDESPREAD VACCINATION IN 2011 IN THOSE DISTRICTS PROVIDED MOST PEOPLE WITH IMMUNITY AGAINST YELLOW FEVER. (THE YELLOW FEVER VACCINE IS PROTECTIVE FOR LIFE)*

SIGNS AND SYMPTOMS OF YELLOW FEVERYellow Fever is a viral hemorrhagic disease. It causes bleeding which may come out from any of the body openings (e.g.: the Nose, Mouth, Bloody stools, Vomiting Blood at the end stage). The symptoms may also include fever with jaundice in the early stages and with multiple organ dysfunctions resulting in kidney and liver failure.

TREATMENT: Treatment is mostly symptomatic.

MODE OF SPREAD: Spread is through the bite of infected Aedes mosquito.

PREVENTIVE MEASURES:1. Prevention is by vaccination - The vaccine is very effective. One injection of the vaccine protects one for life.2. Avoidance and protection against mosquito bites.

CONTAINMENT MEASURES AND RESPONSE ACTIONS DONE1. Public education on signs, symptoms and prevention.2. Yellow Fever vaccination coverage in the affected districts has been assessed & found to be high in those districts. Preventive vaccination coverage was done in the affected communities in 2011 & Yellow fever vaccination protects one for life.

4. Alert sent to all regions and nearby districts of the affected areas.5. Surveillance has been enhanced across the country.

WAY FORWARD:The risk of further transmission is low due to high Yellow fever vaccination coverage in routine EPI and previous preventive vaccination campaign. However, we need to sustain Enhanced surveillance, Intensive public education of the disease, Preventive measures and what to do if one suspects Yellow Fever.

Monday, June 13, 2016

A yellow fever outbreak was detected in Luanda, Angola late in December 2015. The first cases were confirmed by the National Institute for Communicable Diseases (NICD) in South Africa on 19 January 2016 and by the Institut Pasteur Dakar (IP-D) on 20 January. Subsequently, a rapid increase in the number of cases has been observed.

Emergency Committee regarding yellow fever

Following the advice of the Emergency Committee (EC) convened on 19 May 2016, WHO Director-General decided that urban yellow fever outbreaks in Angola and DRC are serious public health events which warrant intensified national action and enhanced international support. The events do not at this time constitute a Public Health Emergency of International Concern (PHEIC).

Statement on the Emergency Committee meeting concerning yellow fever

Summary:

Angola: 2893 suspected cases

As of 1 June 2016, Angola has reported 2893 suspected cases of yellow fever with 325 deaths. Among those cases, 788 have been laboratory confirmed. Despite extensive vaccination campaigns in several provinces, circulation of the virus persists.

Cunene and Malanje provinces have reported, for the first time since the beginning of the outbreak, 5 autochthonous cases.

Democratic Republic of The Congo: 52 laboratory confirmed cases

On 22 March 2016, the Ministry of Health of DRC confirmed cases of yellow fever in connection with Angola. The government officially declared the yellow fever outbreak on 23 April. As of 1 June, DRC has reported three probable cases and 52 laboratory confirmed cases: 44 of those are imported from Angola, reported in Kongo Central, Kinshasa and Kwango (formerly Bandundu) provinces, two are sylvatic cases in Northern provinces, and two other autochthonous cases in Ndjili (Kinshasa) and in Matadi (Kongo Central). The possibility of locally acquired infection is under investigation for at least four non-classified cases.

Uganda: 68 suspect cases

In Uganda, the Ministry of Health notified yellow fever cases in Masaka district on 9 April 2016. As of 1 June, 68 suspected cases, of which three are probable and seven are laboratory confirmed, have been reported from three districts: Masaka, Rukungiri and Kalangala. According to sequencing results, those clusters are not epidemiologically linked to Angola.

The risk of spread

The virus in Angola and DRC is largely concentrated in main cities; however there is a high risk of spread and local transmission to other provinces in both countries. There is also a high risk of potential spread to bordering countries especially those previously classified as low-risk for yellow fever disease (i.e. Namibia, Zambia) and where the population, travellers and foreign workers are not vaccinated against yellow fever.

Three countries have reported confirmed yellow fever cases imported from Angola: Democratic Republic of The Congo (DRC) (44 cases), Kenya (two cases) and People's Republic of China (11 cases). This highlights the risk of international spread through nonimmunised travellers.

A further three countries have reported suspected cases of yellow fever: Republic of Congo (one case), Sao Tome and Principe (two cases) and Ethiopia (22 cases). Investigations are ongoing to identify the vaccination status of the cases and determine if they are linked with Angola.

Risk assessment

The outbreak in Angola remains of high concern due to:

Persistent local transmission in Luanda despite the fact that approximately eight million people have been vaccinated.

Local transmission has been reported in ten highly populated provinces including Luanda. Luanda Norte, Cunene and Malenge are the provinces that most recently reported local yellow fever transmission.

The continued extension of the outbreak to new provinces and new districts.

High risk of spread to neighbouring countries. As the borders are porous with substantial crossborder social and economic activities, further transmission cannot be excluded. Viraemic travelling patients pose a risk for the establishment of local transmission especially in countries where adequate vectors and susceptible human populations are present.

Risk of establishment of local transmission in other provinces where no autochthonous cases are reported.

High index of suspicion of ongoing transmission in hard-to-reach areas like Cabinda.

Inadequate surveillance system capable of identifying new foci or areas of cases emerging.

Sunday, June 12, 2016

This version of the June 8 story corrects the number of cases in the Congo epidemic.)

A new case of yellow fever detected in the Democratic Republic of Congo's capital was transmitted by a local mosquito, the World Health Organisation said on Wednesday, raising the possibility of a wider outbreak of the disease in the country.

The case, confirmed this week after testing by the Pasteur Institute in Dakar and the National Institute of Biomedical Research, was not an imported case from neighbouring Angola as other recent cases were, WHO spokesman Eugene Kabambi said.

"Measures are being taken to strengthen investigation around this case to prevent the spread," Kabambi said in an email. "Social mobilization activities and surveillance are going on with WHO support."

This was the fourth case of the disease transmitted inside the country since March linked to an ongoing epidemic, WHO said.

It was not clear how many mosquitoes in Congo may be carrying yellow fever or what effect this will have on a spread of the virus that has already infected nearly 3,000 people in Angola in the last four months, of which about 325 died, according to WHO.

But yellow fever can spread fast in highly populated areas, with devastating consequences.

So far there have been 52 laboratory-confirmed cases of yellow fever in Congo, most of which have come from Angola. The disease has already spread to Kenya and China and there is an unrelated outbreak in Uganda, generating fears of the mosquito-borne fever jumping to sprawling cities in Asia and Africa.

The outbreaks of yellow fever in Angola and the Congo do not constitute a global health emergency but require stepped-up control measures and mass vaccination, the WHO said last month.

Friday, June 10, 2016

With dangerous yellow fever outbreaks smoldering in a number of African countries and elsewhere, the World Health Organization is set to propose the use of smaller doses of a vaccine to stretch the limited global supply.

Experts at the global health agency are working on a plan that would advise member states to use one-fifth of the normal dose per person, if thecurrent outbreaks cannot be brought under control, a top WHO official told STAT. The proposal comes amid a debate over whether a lower dose would be sufficient to provide protection to children.

Concern about the limited global supply of yellow fever vaccine has been mounting over the past few months as a large and still-spreading outbreak in Angola has seeded cases into Kenya, China, and the Democratic Republic of Congo.

Unrelated outbreaks in Uganda and Peru are putting further pressure on the vaccine supplies.

Alejandro Costa, the WHO team leader for emergency vaccination and stockpiles, said in an interview that an outbreak in the megacity of Kinshasa, capital of the Democratic Republic of Congo, could trigger a plan to use smaller doses of the vaccine. Kinshasa has a population of 12 million to 14 million people; the WHO has only 6 million doses of yellow fever vaccine stockpiled.

“If we have to vaccinate Kinshasa,” where there is already evidence the virus is being transmitted locally, “we don’t have enough vaccine today,” Costa said.

Brazzaville, the capital of the Republic of Congo, sits across the Congo River. Yellow fever spreading in Kinshasa would likely mean Brazzaville’s estimated 1.8 million inhabitants would also need to be vaccinated.

“If it goes to Brazzaville, the situation would be even worse,” Costa said.

Yellow fever is a disease caused by a virus that infects monkeys and people. It is transmitted by Aedes mosquitoes — the same mosquitoes that transmit the Zika virus — and normally spreads among primates in the Amazon and forested parts of Africa, only occasionally infecting humans. From time to time, however, the virus starts to spread among people.

People who contract the virus experience fever, headache, backache, muscle pain, loss of appetite, and nausea or vomiting. For most people, symptoms last three or four days, the WHO says.

About 15 percent of people go on to suffer from a second, more severe phase of the illness, when jaundice develops — hence the name yellow fever. Roughly half of people who develop a toxic phase die.

Experts have been calling on the WHO to recommend countries use fractional doses of the scarce vaccine for some time. In mid-April, some leading yellow fever experts argued for the approach in the journal The Lancet.

It would not be the first time the WHO has recommended using fractional doses of vaccine to stretch supplies. It’s currently doing so with injectable polio vaccine as a stopgap measure to deal with a global shortage.

With yellow fever vaccine, studies, mainly done in Brazil, have suggested that far smaller doses than normally used can protect against the disease.

But the studies were conducted in adults only, leaving questions about whether smaller doses would protect children, who generally require higher doses.

“If we make a mistake and children die, that would be terrible,” said Alan Barrett, director of the Sealy Center for Vaccine Development at the University of Texas Medical Branch in Galveston.

“We’ve got to be careful.”

Yellow fever hits Angola hard

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HYACINTH EMPINADO/STAT

Here's what you should know about the yellow fever outbreak happening in Angola right now.

So far this year the WHO — and the partners with which it maintains a yellow fever vaccine stockpile — have sent 13 million doses to Angola. But spread there continues, Costa said.

Under the WHO proposal, the standard dose would be reduced and recipients would be revaccinated later, when supplies are available, Costa said. It’s not known if giving a smaller dose will provide the lifelong immunity a standard dose of yellow fever vaccine confers.

The plan will be submitted, potentially as early as next week, to the WHO’s vaccine advisers, the Strategic Advisory Group of Experts on Immunization. The group is known as the SAGE.

If the SAGE accepts the proposal, it would advise countries using the vaccine to lower the per-person dose.

The next meeting of the group isn’t scheduled until October, but an emergency session would be called to debate the proposal if the need arises, Costa said.

The idea is to approve the dose-sparing regimen on an emergency-use basis. That would not permanently change the amount of vaccine used in yellow fever vaccine.

Sunday, June 5, 2016

Persons intending to travel to Yellow Fever affected areas now have greater access to vaccinations. This as the Ministry of Health has increased the number of days Yellow Fever vaccinations are administered. The decision was made based on the increase in the number of persons attending health centres recently for Yellow Fever vaccination.

The new schedule to access Yellow Fever vaccinations started on Monday. Yellow Fever vaccinations will be administered at the Slipe Pen Road Comprehensive Health Centre in Kingston on Tuesdays, Thursdays and Fridays from 8:30 a.m. to 4 p.m.; and the Montego Bay Type 5 Health Centre in St James every Monday, Wednesday and Thursday from 10 a.m. to 2 p.m. The cost is $1,500 per vaccine. It is also advised that the vaccines be (done) administered at least ten (10) days prior to travel. In order to reduce waiting time persons, especially groups, are being asked to make appointments.

The Ministry is reiterating the importance of persons getting vaccinated when travelling to or transiting through affected countries as has always been required. The Ministry recently increased public education on the matter in light of the current Yellow Fever outbreak in Angola and ongoing transmission in the Americas.

Health Minister, Dr Christopher Tufton, says “We are trying to make the public aware of this possible threat and in so doing reduce the risk of persons becoming ill by encouraging everyone to get vaccinated once travelling to or transiting through an area with risk of Yellow Fever transmission".

Yellow Fever is an acute illness caused by the yellow fever virus which is found in the tropics of South America and Africa. The virus is transmitted by the bite of infected mosquitoes such as the Aedes; the same vector that transmits the Chikungunya, Dengue and Zika viruses.

Yellow Fever is a Class 1 notifiable disease which means it is to be reported to the Ministry of Health within 24 hours on suspicion by a healthcare professional.

Comment: I believe that it is time that the Indian Government also considers increasing the number of days that Yellow fever vaccination is administered in various centers in our country. Also, private centers should be licensed by the GOI to allow easy access to travelers to Africa and South America, for Stamaril, Yellow fever vaccination.

The European Centre for Disease Prevention and Control has updated its rapid risk assessment on the outbreak of yellow fever with the latest developments, more comprehensive information on the current situation in Angola, Democratic Republic of Congo (DRC) and Uganda and an extended threat assessment for the EU. Some of the data used in the assessment were collected during a mission to Angola in May 2016.

FULL STORY

ECDC has updated its rapid risk assessment on the outbreak of yellow fever with the latest developments, more comprehensive information on the current situation in Angola, Democratic Republic of Congo (DRC) and Uganda and an extended threat assessment for the EU.

Some of the data used in the assessment were collected during a mission to Angola in May 2016.

Current situation

From 21 January to 22 May 2016, the Angolan Ministry of Health notified 2 536 yellow fever cases, of which 747 were confirmed and 301 fatal. The number of new suspected and confirmed cases in Angola has been decreasing and a mass vaccination campaign has already reached about half of the targeted population. However, the outbreak in Angola is not yet under control and is currently expanding to additional provinces, further challenging the ongoing mass vaccination campaign. Currently, all regions in Angola should be considered as areas at high risk of transmission of yellow fever.

The yellow fever outbreak in Uganda is unrelated to the outbreak in Angola. Between 26 March and 19 May 2016, health authorities reported 60 yellow fever cases, including seven deaths in six different districts.

As of 23 May, DRC has reported 590 cases of yellow fever, 41 of these had a recent travel history to Angola.

Viraemic patients travelling to areas where suitable vectors and susceptible human populations are present pose a risk for local transmission. Such areas exist in most of the inter-tropical zones of Africa, and the Americas and Asia.

Therefore, the risk of international spread within Africa and beyond is currently high.

ECDC threat assessment for the EU

In the EU/EEA, the risk of yellow fever virus being introduced is limited to unvaccinated viraemic travellers coming from areas with active local transmission. Given that outbreaks of yellow fever in urban settings have the potential for rapid spread and that significant yellow fever epidemics are ongoing in Angola, DRC and Uganda, a range of options for response by EU/EEA Member States are presented in the updated rapid risk assessment. These options emphasize the importance of vaccination of travellers and those leaving Angola, preventive measures against mosquito bites in affected areas, as well as awareness raising among clinicians to consider this diagnosis in returning travellers.

About Me

I am a pediatrician based at Mohali, a suburb of chandigarh, North India. I have my own virtual office at www.charakclinics.com; I have been a pediatrician since 1994. I hope to make ths blog a regular feature with tonnes of relevant info for parents, especially in India, because i feel that "informed parents are better parents". My interests include research in OPD practice, specifically new vaccines and travel medicine. I am a member of American Academy of Pediatrics, Indian Academy of Pediatrics, and various travel organizations like International Society for Travel Medicine (ISTM), American Society of Tropical Medicine & Hygiene (ASTMH), International Association for Medical Assistance to Travelers (IAMAT), and British & Global Travel Health Association (BGTHA)